Can traction therapy help many individuals dealing with low back pain reduce inflammation and improve quality of life?
Introduction
When many individuals do everyday activities, if they are not careful, they can cause pain-like issues such as muscle strain, stiffness, and aches in different locations in the upper and lower portions of their bodies. When this happens, it can lead to the body’s natural defense, known as inflammation. Inflammation is the immune system’s natural defense to heal the affected area in the body naturally. However, depending on the severity of the issue causing the person to be in pain, inflammation can be beneficial or harmful. When many individuals start to make repetitive motions to their bodies, it can cause the muscle and tissue fibers to be overstretched and ache. To that point, these repetitive motions to the body could potentially lead to low back pain. Have you or your loved ones experienced inflammatory effects that lead to low back pain? When this happens, many individuals seek non-surgical treatments to reduce inflammation in the lower back, which can help restore their quality of life. Today’s article post looks at the correlation between inflammation and low back pain and how non-surgical treatments like traction therapy can reduce inflammation and restore a person’s quality of life. Coincidentally, we communicate with certified medical providers who incorporate our patients’ information to ease low back pain associated with inflammation that leads to the development of musculoskeletal disorders. We also inform them that non-surgical treatments like traction therapy can help reduce the chronic inflammatory effects in the body. We encourage our patients to ask amazing educational questions to our associated medical providers about their symptoms correlating with low back pain. Dr. Jimenez, D.C., incorporates this information as an academic service. Disclaimer
Inflammation Correlating With Low Back Pain
Do you often experience muscle aches in your lower back after a long, hard workday? Do you feel your skin is so hot to the touch that it is causing your muscles to ache constantly? Or did you injure your back due to improper lifting, so the pain is unbearable? Many individuals don’t often realize that the scenarios they are doing in their daily lives correspond to the development of low back pain. Low back pain is a multifactorial musculoskeletal disorder with many symptoms that are often correlated with inflammation. Inflammation is the body’s immune defense that starts to heal the affected area where the body has succumbed to injuries. Inflammation can be beneficial and harmful in its acute and chronic form while correlating with low back pain. When it comes to low back pain, its factors can lead to lumbar disc herniation, which then can be highly associated with inflammation. (Cunha et al., 2018) This is due to the surrounding nerve roots being entrapped, and the adverse symptoms of the lower back start to stimulate the nerve fibers to evoke inflammation, leading to pain-like issues in the lower extremities. When the lower extremities are associated with lower back pain, the lumbar components will start to degenerate over time, activating the inflammatory cytokine pathways that can directly damage the nerves and lower nociceptors, causing pain to the legs and lower back. (Li et al., 2021) When inflammation correlates with low back pain, it is a recurrent condition that many individuals seek treatment from their primary doctors. (Von Korff & Saunders, 1996) When this happens, many individuals incorporate these treatments to reduce inflammation and restore their quality of life.
Fighting Inflammation Naturally-Video
When inflammation is correlated with low back pain, many individuals will seek affordable treatment that works with their hectic schedules. Non-surgical treatments can work around a person’s schedule and are cost-effective. Treatments like traction therapy, massage therapy, chiropractic care, physical therapy, and spinal decompression are all non-surgical treatments that utilize manual and mechanical manipulation to relieve people suffering from low back pain and reduce the effects of inflammation affecting the lower extremities. These non-surgical treatments can relieve many individuals after a few consecutive sessions and slowly reduce the inflammatory effects. The video above shows how non-surgical treatment can help restore the body while naturally reducing inflammatory outcomes in a personalized treatment plan.
How Traction Reduces Inflammation
When it comes to treating low back pain correlating with inflammation, traction therapy, a form of non-surgical treatment, can be beneficial in reducing these pain-like issues. The pain specialist first assesses individuals with inflammation correlating with low back pain as they note where the pain affects them in their bodies. Afterward, they will be strapped into a traction machine, gently pulling their spines to reduce pain involving the aggravated nerves and muscles. The intervertebral discs will also be increased during traction to improve the spinal disc height. (Andersson, Schultz, & Nachemson, 1983) This allows the affected nerve roots to stop pain signals from affecting the lower extremities and promote healing. Traction therapy can even decompress the nucleus pulposus, one of the effects of low back pain, by pulling it back to its original position. (Ramos & Martin, 1994) This, in turn, reduces the inflammatory effects and allows the body to heal itself naturally.
Traction Therapy Restoring Quality Of Life
When many individuals incorporate traction therapy, it can restore their quality of life. Traction therapy can help reduce the symptoms of inflammation and pain by minimizing the chances of needing surgery. (Wang et al., 2022) Traction therapy can also be combined with manual therapy to stretch and strengthen the surrounding weak muscles and help restore the joint’s mobility. (Kuligowski, Skrzek, & Cieslik, 2021) To that point, many individuals dealing with inflammation correlating with low back pain can notice their pain being diminished and be more mindful of what habits are the root causes of their pain and how to reduce them from causing the pain to return.
References
Andersson, G. B., Schultz, A. B., & Nachemson, A. L. (1983). Intervertebral disc pressures during traction. Scand J Rehabil Med Suppl, 9, 88-91. www.ncbi.nlm.nih.gov/pubmed/6585945
Cunha, C., Silva, A. J., Pereira, P., Vaz, R., Goncalves, R. M., & Barbosa, M. A. (2018). The inflammatory response in the regression of lumbar disc herniation. Arthritis Res Ther, 20(1), 251. doi.org/10.1186/s13075-018-1743-4
Kuligowski, T., Skrzek, A., & Cieslik, B. (2021). Manual Therapy in Cervical and Lumbar Radiculopathy: A Systematic Review of the Literature. Int J Environ Res Public Health, 18(11). doi.org/10.3390/ijerph18116176
Li, W., Gong, Y., Liu, J., Guo, Y., Tang, H., Qin, S., Zhao, Y., Wang, S., Xu, Z., & Chen, B. (2021). Peripheral and Central Pathological Mechanisms of Chronic Low Back Pain: A Narrative Review. J Pain Res, 14, 1483-1494. doi.org/10.2147/JPR.S306280
Ramos, G., & Martin, W. (1994). Effects of vertebral axial decompression on intradiscal pressure. J Neurosurg, 81(3), 350-353. doi.org/10.3171/jns.1994.81.3.0350
Von Korff, M., & Saunders, K. (1996). The course of back pain in primary care. Spine (Phila Pa 1976), 21(24), 2833-2837; discussion 2838-2839. doi.org/10.1097/00007632-199612150-00004
Wang, W., Long, F., Wu, X., Li, S., & Lin, J. (2022). Clinical Efficacy of Mechanical Traction as Physical Therapy for Lumbar Disc Herniation: A Meta-Analysis. Comput Math Methods Med, 2022, 5670303. doi.org/10.1155/2022/5670303
Individuals who have suffered cervical acceleration-deceleration/CAD more commonly known as whiplash, can experience headaches, and other symptoms like neck stiffness, pain, fatigue, and shoulder/neck/back discomfort. Can non-surgical and conservative treatments help alleviate the symptoms?
Cervical Acceleration – Deceleration or CAD
Cervical acceleration-deceleration is the mechanism of a neck injury caused by a forceful back-and-forth neck motion. It happens most commonly in rear-end vehicle collisions when the head and neck whip forward and backward with intense acceleration and/or deceleration causing the neck to flex and/or extend rapidly, more than normally, straining and possibly tearing muscle tissues and nerves, ligaments, dislocation of spinal discs and herniations, and cervical bone fractures.
For symptoms that do not improve or worsen after 2 to 3 weeks, see a healthcare provider or chiropractor for further evaluation and treatment.
Whiplash injuries strain or sprain the neck muscles and/or ligaments, but can also affect the vertebrae/bones, disc cushions between the vertebrae, and/or the nerves.
Whiplash symptoms can present right away, or after several hours to a few days after the incident, and tend to worsen in the days after the injury. Symptoms can last a few weeks to a few months, and can severely limit activity and range of motion. Symptoms can include: (National Institute of Neurological Disorders and Stroke. 2023)
Pain that extends into the shoulders and back.
Neck stiffness
Limited neck motion
Muscle spasms
Numbness and tingling sensations – paresthesias or pins and needles in the fingers, hands, or arms.
Headaches – A whiplash headache usually starts at the base of the skull and can vary in intensity. Most individuals experience pain on one side of the head and toward the back, though some can experience symptoms all over their head, and a small number experience headaches on the forehead or behind the eyes. (Monica Drottning. 2003)
The headaches can become aggravated by moving the neck around, especially when looking up.
Headaches are often associated with shoulder pain along with sensitive neck and shoulder muscles that when touched can increase pain levels.
Whiplash headaches can lead to chronic neck-related headaches known as cervicogenic headaches. (Phil Page. 2011)
It is also important to rest your neck area following the injury.
A cervical collar can be utilized temporarily to stabilize the neck, but for long-term recovery, it is recommended to keep the area mobile.
Physical activity reduction until the individual can look over both shoulders, and tilt their head all the way forward, all the way back, and from side to side without pain or stiffness.
Non-steroidal anti-inflammatories – NSAIDs – Ibuprofen or Naproxen.
Muscle relaxers
If symptoms do not improve, a healthcare provider may recommend physical therapy and/or stronger pain medications. For whiplash headaches that last for several months, acupuncture, or spinal injections may be recommended.
Neck Injuries
References
National Institute of Neurological Disorders and Stroke. Whiplash Information Page.
Drottning M. (2003). Cervicogenic headache after a whiplash injury. Current pain and headache reports, 7(5), 384–386. doi.org/10.1007/s11916-003-0038-9
Page P. (2011). Cervicogenic headaches: an evidence-led approach to clinical management. International journal of sports physical therapy, 6(3), 254–266.
Can lumbar traction therapy alleviate an individual’s lower back pain by restoring weak trunk muscles over time?
Introduction
The trunk muscles are the body’s main stabilizers that support upper body weight and stabilize the lower body weight. These muscles work with the lumbar back muscles so the individual can maintain good posture and be mobile when in motion without pain. However, when traumatic or normal forces start to affect the trunk muscles, it can lead to unwanted musculoskeletal pain that can lead to a life of disability and affect their performance in their routine. Weak truck muscles can lead to low back pain issues while causing referred pain to the lower extremities. However, many individuals are finding ways to strengthen their trunk muscles by slowly integrating core exercises and going to non-surgical treatments to reduce the pain they have been experiencing. Today’s article looks at how weak truck muscles correlate with low back pain and how non-surgical treatments like lumbar traction can reduce pain associated with weak trunk muscles. Additionally, we communicate with certified medical providers who incorporate our patients’ information to ease low back pain associated with weak trunk muscles, causing many musculoskeletal issues in the lower body. We also inform them that non-surgical treatments can help re-strengthen the truck muscles. We encourage our patients to ask amazing educational questions for our associated medical providers about their symptoms correlating with weak trunk muscles. Dr. Jimenez, D.C., incorporates this information as an academic service. Disclaimer
Weak Trunk Muscles Correlate With Low Back Pain
Do you often experience low back pain after carrying a heavy object from one location to another at work? Do you slouch more than usual when you are relaxing at home? Or have you noticed that you can’t hold a plank for less than 30 seconds during a workout? Many individuals dealing with these issues in these scenarios could be dealing with weak core muscles that can lead to low back pain. Since low back pain is a common problem that many people have, some of the correlating factors could be weak trunk muscles. Weak trunk muscles in the body can be due to the body naturally degenerating, causing the intervertebral disc to deteriorate. When the water content and spinal disc height begin to go through mechanical changes from unwanted pressure loads, it can cause the intervertebral discs to bulge out of the spine more and cause the surrounding ligaments and muscles to deal with more stress and become weak over time. (Adams et al., 1990) When the trunk muscles weaken, the lower extremities will start to develop musculoskeletal conditions that can lead to pain. Spinal disorders develop over time when normal or traumatic forces begin to affect the quality and quantity of the trunk muscle functions for its range of motion, strength, and endurance when a person is doing normal activities. (Allen, 1988)
So how would weak trunk muscles and low back pain have this relationship to affect a person’s spine? When muscle activity begins to be reduced within the trunk region, symptoms like stiffness and pain can cause postural shrinkage to the spinal disc in the lumbar region. (Cholewicki, 2004) Additionally, when dealing with low back pain, their trunk muscles undergo structural changes that can affect their stability. These changes can lead to reduced movement speed and range of motion, which then causes many of the accessory muscles to compensate for the pain that the person is experiencing. (Van Dieën, Cholewicki, & Radebold, 2003) However, numerous individuals will opt for a treatment plan to reduce low back pain and also help strengthen weak core muscles.
Can Core Exercises Help With Back Pain?-Video
When it comes to strengthening and restoring weak muscles to reduce low back pain, many individuals will try exercising to lessen the pain they are experiencing in their lumbar spine and strengthen their weakened core muscles. The video above indicates that including core strengthening workouts in a workout routine can be essential to pain management. Exercising alone can be challenging without the right motivation, but it can be included in a personalized treatment plan that can be effective and customizable to manage lumbar impairment. (Li & Bombardier, 2001) Many individuals opt for non-surgical treatments due to their cost-effectiveness and how safe it is on the spine to reduce muscle weakness within the trunk muscles.
Lumbar Traction Restoring Weak Trunk Muscles
When dealing with weak trunk muscles correlating with low back pain, incorporating non-surgical treatment could be the answer to reducing the pain they have been experiencing. Non-surgical treatments like lumbar traction, spinal decompression, massage therapy, physical therapy, and chiropractic care utilize mechanical and manual techniques to reduce pain in the upper and lower body portions, help stretch out shortened and tight muscles, and kick-start the body’s natural healing process. Since lumbar traction is a non-surgical treatment, it can help restore muscle strength within the trunk region. Lumbar traction can be used manually or mechanically to increase intervertebral disc space, decrease mechanical stress, and reduce muscle spasms. (Wegner et al., 2013) When many individuals feel relief from their pain and strengthen their trunk muscles gradually, they will notice a difference in their routine and continue to be pain-free after a few session treatments.
References
Adams, M. A., Dolan, P., Hutton, W. C., & Porter, R. W. (1990). Diurnal changes in spinal mechanics and their clinical significance. J Bone Joint Surg Br, 72(2), 266-270. doi.org/10.1302/0301-620X.72B2.2138156
Allen, M. E. (1988). Clinical kinesiology: measurement techniques for spinal disorders. Orthop Rev, 17(11), 1097-1104. www.ncbi.nlm.nih.gov/pubmed/3205587
Cholewicki, J. (2004). The effects of lumbosacral orthoses on spine stability: what changes in EMG can be expected? J Orthop Res, 22(5), 1150-1155. doi.org/10.1016/j.orthres.2004.01.009
Li, L. C., & Bombardier, C. (2001). Physical therapy management of low back pain: an exploratory survey of therapist approaches. Phys Ther, 81(4), 1018-1028. www.ncbi.nlm.nih.gov/pubmed/11276184
Van Dieën, J. H., Cholewicki, J., & Radebold, A. (2003). Trunk Muscle Recruitment Patterns in Patients With Low Back Pain Enhance the Stability of the Lumbar Spine. Spine, 28(8), 834-841. doi.org/10.1097/01.brs.0000058939.51147.55
Wegner, I., Widyahening, I. S., van Tulder, M. W., Blomberg, S. E., de Vet, H. C., Bronfort, G., Bouter, L. M., & van der Heijden, G. J. (2013). Traction for low-back pain with or without sciatica. Cochrane Database Syst Rev, 2013(8), CD003010. doi.org/10.1002/14651858.CD003010.pub5
For individuals with peanut allergies, can finding a peanut alternative be as satisfying as a real creamy or crunchy peanut butter sandwich?
Peanut Butter Sandwich Alternatives
For individuals who are unable to have a peanut butter sandwich due to an allergy, there are healthy satisfying alternatives. Tree nut butter, seed butter, and deli meats can all satisfy sandwich cravings and provide nutrition. Here are a few healthy, nutritious alternatives to try out:
Sunflower Seed Butter and Jam, Jelly, or Preserves
It can be substituted for a PBJ with jam, jelly, and preserves.
Ham and Cheese, Grainy Mustard on Rye Bread
Getting ham and cheese from the deli can potentially have cross-contamination with allergens during slicing and packaging.
Prepackaged and sliced ham and cheese is a safer bet in terms of allergens.
It is recommended to read the ingredient label for potential allergens, as processing in facilities can have cross-contamination issues. (William J. Sheehan, et al., 2018)
Turkey, Tomato, Lettuce, and Hummus on Whole Grain Bread
The same is true for turkey and is recommended to buy prepackaged and sliced.
Check the ingredients for possible allergens.
Hummus is made from chickpeas/garbanzo beans and tahini/ground sesame seeds.
Hummus comes in a variety of flavors that can be used as a dip or spread.
Although chick peas’ are a member of the legume family, hummus can be tolerated with peanut allergies. (Mathias Cousin, et al., 2017)
Check with a healthcare provider if unsure.
Pita Pocket with Salad and Hummus
Pita pockets are great with hummus stuffed with vegetables.
This is a delicious crunchy pocket sandwich loaded with protein, fiber vitamins, and minerals.
Cashew butter on a hot English muffin with raisins on top for a boost of iron is reminiscent of a cinnamon roll.
Pumpkin Seed Butter and Honey Sandwich
Pumpkin butter is made from the orange flesh of the pumpkin.
Pumpkin seed butter is made by roasting pumpkin seeds and grinding them to a butter consistency.
The seed butter can be spread on bread and drizzled with some honey on top for a nutritious and delicious snack.
There are tasty healthy peanut butter alternatives that can be mixed, matched, and reinvented into various satisfying sandwiches. Individuals are recommended to consult their healthcare provider or a dietician or nutritionist to find what works for them.
Smart Choices, Better Health
References
Lavine, E., & Ben-Shoshan, M. (2015). Allergy to sunflower seed and sunflower butter as a proposed vehicle for sensitization. Allergy, asthma, and clinical immunology: Official Journal of the Canadian Society of Allergy and Clinical Immunology, 11(1), 2. doi.org/10.1186/s13223-014-0065-6
U.S. Department of Agriculture: FoodData Central. Seeds, sunflower seed butter, with salt added (Includes foods for USDA’s Food Distribution Program).
Sheehan, W. J., Taylor, S. L., Phipatanakul, W., & Brough, H. A. (2018). Environmental Food Exposure: What Is the Risk of Clinical Reactivity From Cross-Contact and What Is the Risk of Sensitization. The journal of allergy and clinical immunology. In practice, 6(6), 1825–1832. doi.org/10.1016/j.jaip.2018.08.001
Gorrepati, K., Balasubramanian, S., & Chandra, P. (2015). Plant-based butters. Journal of food science and technology, 52(7), 3965–3976. doi.org/10.1007/s13197-014-1572-7
Cousin, M., Verdun, S., Seynave, M., Vilain, A. C., Lansiaux, A., Decoster, A., & Sauvage, C. (2017). Phenotypical characterization of peanut-allergic children with differences in cross-allergy to tree nuts and other legumes. Pediatric allergy and immunology: Official publication of the European Society of Pediatric Allergy and Immunology, 28(3), 245–250. doi.org/10.1111/pai.12698
Almond Board of California. Nutrient comparison chart for tree nuts.
American Academy of Allergy, Asthma and Immunology. Everything you need to know about a tree nut allergy.
How does innovated non-surgical treatment help assist individuals with cervical spinal pain to reduce headaches?
Introduction
Do you or your loved ones often experience headaches that don’t disappear? Do you often feel your shoulder and neck muscles ache after looking down at your cell phone? Or do you feel aches after being slouched for an extended period? Many of these scenarios correlate with referred pain in the cervical spinal region, which can develop into neck pain. The neck region is located in the upper body portion and provides mobility for the head without pain and discomfort. The neck region also has surrounding muscles and ligaments that support the spine and protects the thyroid and spinal cord. However, just like the back region, it is susceptible to pain as many individuals can overstretch the neck muscles, and it can cause referred pain to the shoulders and head, leading to pain-like symptoms that can lead to a life of disability. However, non-surgical treatments can minimize the pain and help strengthen the surrounding muscles in the neck region. Today’s article focuses on how cervical spinal pain connects with headaches and how decompression can reduce headaches while relieving neck pain. Additionally, we communicate with certified medical providers who incorporate our patients’ information to reduce cervical spinal pain associated with headaches, causing many musculoskeletal issues in the upper body portion. We also inform them that non-surgical treatments can help relieve headaches and provide relief to the neck region. We encourage our patients to ask amazing educational questions for our associated medical providers about their symptoms correlating with cervical spinal pain. Dr. Jimenez, D.C., incorporates this information as an academic service. Disclaimer
Cervical Spinal Pain & Headache Connection
Throughout the world, neck pain (cervical spinal pain) is the second most common problem that can affect many individuals throughout their lives. It can lead to a life of disability and pain if not treated immediately. Many individuals often experience non-specific neck pain, as it can be through a postural or mechanical basis that can cause muscle strain in the surrounding muscles or compress the spinal canal to cause headaches that can last throughout the entire day. (Binder, 2008) Additionally, neck pain, like back pain, is a multifactorial disease with common risk factors like lack of physical activity, duration of computer usage, and perceived stress. (Kazeminasab et al., 2022) Many of these risk factors are normal as they can also affect the surrounding muscles in the lower back region and shoulder region, as many people often do repetitive motions that can naturally be overstretched and cause pain-like issues to the neck region. With neck pain connected with headaches, it can cause overlapping risk profiles and be costly. Neck pain associated with headaches can be a frequent and expensive occupational health problem as symptoms of pain, disability, reduced life quality, and, for adults, time lost for work. (Ben Ayed et al., 2019)
The correlation between headaches and neck pain is that the spinal canal is compressed from traumatic forces that can lead to cervicogenic headaches. Cervicogenic headaches usually aggravate neck mobility, thus reducing the ROM of the neck. (Verma, Tripathi, & Chandra, 2021) This can lead to many individuals suffering from migraine-like headaches and muscle stiffness in the upper regions of the body. When many individuals are dealing with headaches associated with cervical spinal pain, many will find treatments to mitigate the pain-like symptoms affecting the upper body region.
The Benefits Of Stretching-Video
When it comes to neck pain, it can be either acute or chronic depending the factors that cause it or the severity of the pain. Many individuals sought treatment that can alleviate the pain in the upper regions that are non-surgical and beneficial to their health and well-being. Non-surgical treatments can help stretch the tight and short muscles in the neck region and can reduce headaches affecting the person. Additionally, having the neck muscles professionally stretched by a massage therapist can relieve the neck and reduce headaches. The video above explains the benefits of stretching and describes how many people don’t stretch their bodies often to prevent pain-like issues from reoccurring in the future.
Spinal Decompression For Cervical Pain
Non-surgical treatments are excellent when it comes to reducing neck pain. When relieving neck pain, healthcare professionals must use the best available evidence to enhance clinical decision-making and improve the quality of care for people with neck pain. (Misailidou et al., 2010) Spinal decompression can help many people with neck pain by reducing the issues through gentle spinal traction. What spinal decompression does for the cervical spine is that it can realign the disc that is aggravating the neck region and causing headaches by stretching the surrounding muscles. This causes muscle improvement for the neck as it can change the patient’s pain outcome. (Youssef et al., 2019) Additionally, spinal decompression is safe, cost-effective, and gentle on the spine as it can be combined with other therapies to mitigate any residual pain that can relieve the neck and back. (Flynn, 2020) Many people who incorporate spinal decompression as part of their routine can benefit from their outcome as they return to their routine.
References
Ben Ayed, H., Yaich, S., Trigui, M., Ben Hmida, M., Ben Jemaa, M., Ammar, A., Jedidi, J., Karray, R., Feki, H., Mejdoub, Y., Kassis, M., & Damak, J. (2019). Prevalence, Risk Factors and Outcomes of Neck, Shoulders and Low-Back Pain in Secondary-School Children. J Res Health Sci, 19(1), e00440. www.ncbi.nlm.nih.gov/pubmed/31133629
Flynn, D. M. (2020). Chronic Musculoskeletal Pain: Nonpharmacologic, Noninvasive Treatments. American Family Physician, 102(8), 465-477. www.ncbi.nlm.nih.gov/pubmed/33064421
Kazeminasab, S., Nejadghaderi, S. A., Amiri, P., Pourfathi, H., Araj-Khodaei, M., Sullman, M. J. M., Kolahi, A. A., & Safiri, S. (2022). Neck pain: global epidemiology, trends and risk factors. BMC Musculoskelet Disord, 23(1), 26. doi.org/10.1186/s12891-021-04957-4
Misailidou, V., Malliou, P., Beneka, A., Karagiannidis, A., & Godolias, G. (2010). Assessment of patients with neck pain: a review of definitions, selection criteria, and measurement tools. J Chiropr Med, 9(2), 49-59. doi.org/10.1016/j.jcm.2010.03.002
Verma, S., Tripathi, M., & Chandra, P. S. (2021). Cervicogenic Headache: Current Perspectives. Neurol India, 69(Supplement), S194-S198. doi.org/10.4103/0028-3886.315992
Youssef, J. A., Heiner, A. D., Montgomery, J. R., Tender, G. C., Lorio, M. P., Morreale, J. M., & Phillips, F. M. (2019). Outcomes of posterior cervical fusion and decompression: a systematic review and meta-analysis. Spine J, 19(10), 1714-1729. doi.org/10.1016/j.spinee.2019.04.019
The Q or quadriceps angle is a measurement of pelvic width that is believed to contribute to the risk of sports injuries in women athletes. Can non-surgical therapies and exercises help rehabilitate injuries?
Quadriceps Q – Angle Injuries
The Q angle is the angle where the femur/upper leg bone meets the tibia/lower leg bone. It is measured by two intersecting lines:
One from the center of the patella/kneecap to the anterior superior iliac spine of the pelvis.
The other is from the patella to the tibial tubercle.
On average the angle is three degrees higher in women than men.
Women have biomechanical differences that include a wider pelvis, making it easier to give birth. However, this difference can contribute to knee injuries when playing sports, as an increased Q angle generates more stress on the knee joint, as well as leading to increased foot pronation.
Injuries
Various factors can increase the risk of injury, but a wider Q angle has been linked to the following conditions.
Patellofemoral Pain Syndrome
An increased Q angle can cause the quadriceps to pull on the kneecap, shifting it out of place and causing dysfunctional patellar tracking.
With time, this can cause knee pain (under and around the kneecap), and muscle imbalance.
Foot orthotics and arch supports could be recommended.
Some researchers have found a link, while others have not found the same association. (Wolf Petersen, et al., 2014)
Chondromalacia of the Knee
This is the wearing down of the cartilage on the underside of the kneecap.
An increased Q angle can be a factor that increases stress and causes the knee to lose its stability.
However, this remains controversial, as some studies have found no association between the Q angle and knee injuries.
Chiropractic Treatment
Strengthening Exercises
ACL injury prevention programs designed for women have resulted in reduced injuries. (Trent Nessler, et al., 2017)
The vastus medialis obliquus or VMO is a teardrop-shaped muscle that helps move the knee joint and stabilize the kneecap.
Strengthening the muscle can increase the stability of the knee joint.
Strengthening may require a specific focus on muscle contraction timing.
Closed-chain exercises like wall squats are recommended.
Glute strengthening will improve stability.
Stretching Exercises
Stretching tight muscles will help relax the injured area, increase circulation, and restore range of motion and function.
Muscles commonly found to be tight include the quadriceps, hamstrings, iliotibial band, and gastrocnemius.
Foot Orthotics
Custom-made, flexible orthotics decrease the Q angle and reduce pronation, relieving the added stress on the knee.
A custom orthotic ensures that the foot and leg dynamics are accounted for and corrected.
Motion-control shoes can also help correct overpronation.
Knee Rehabilitation
References
Khasawneh, R. R., Allouh, M. Z., & Abu-El-Rub, E. (2019). Measurement of the quadriceps (Q) angle with respect to various body parameters in young Arab population. PloS one, 14(6), e0218387. doi.org/10.1371/journal.pone.0218387
Petersen, W., Ellermann, A., Gösele-Koppenburg, A., Best, R., Rembitzki, I. V., Brüggemann, G. P., & Liebau, C. (2014). Patellofemoral pain syndrome. Knee surgery, sports traumatology, arthroscopy: Official journal of the ESSKA, 22(10), 2264–2274. doi.org/10.1007/s00167-013-2759-6
Vaienti, E., Scita, G., Ceccarelli, F., & Pogliacomi, F. (2017). Understanding the human knee and its relationship to total knee replacement. Acta bio-medica : Atenei Parmensis, 88(2S), 6–16. doi.org/10.23750/abm.v88i2-S.6507
Mitani Y. (2017). Gender-related differences in lower limb alignment, range of joint motion, and the incidence of sports injuries in Japanese university athletes. Journal of Physical Therapy Science, 29(1), 12–15. doi.org/10.1589/jpts.29.12
Nessler, T., Denney, L., & Sampley, J. (2017). ACL Injury Prevention: What Does Research Tell Us? Current reviews in musculoskeletal medicine, 10(3), 281–288. doi.org/10.1007/s12178-017-9416-5
Temporomandibular joint disorder causes pain and jaw locking that can be worsened with certain activities. How individuals can manage and prevent flare-ups by learning what not to do to worsen the condition?
What Not To Do Temporomandibular Joint Disorder
Tenderness, aching, pain, and jaw locking are symptoms of temporomandibular joint disorder or TMJ. The temporomandibular joint connects the jaw to the skull. It is used daily for eating, drinking, and talking. It is a small disc in the joint that allows the jaw bones to slip and slide correctly. With TMJ, the disc shifts out of place, leading to clicking, snapping, and limited jaw movement. It can also cause pain in the jaw and face, neck pain, and headaches, and the muscles around the jaw and neck can become sore and/or go into spasm. Any type of activity that stresses or overworks the joint can trigger a flare-up and worsen TMJ symptoms. (Schiffman E, et al. 2014) This article looks at avoiding activities that make TMJ worse and what not to do to help keep TMJ symptoms in check.
Chewing Gum
Gum chewing is not recommended for individuals with TMJ.
The jaw is one of the most used joints in the body.
Limiting excessive use alleviates pressure allowing the joints and muscles to rest.
Resting sore muscles and joints is the first step in injury recovery.
Eating Chewy and Hard Foods
Chewy and hard foods make the jaw have to work overtime.
Avoid eating hard foods like chewy candies, hard and chewy breads, vegetables like corn on the cob, and fruits like apples.
These foods can place excessive stress on the jaw, and prevent the joint from properly resting and healing.
Chewing Only On One Side
Many individuals chew their food on only one side of the mouth.
This can stress out one side of the temporomandibular joint and surrounding muscles, leading to pain and dysfunction. (Urbano Santana-Mora, et al., 2013)
Stay aware of chewing habits and make sure to utilize both sides of the mouth.
Individuals with dental issues or tooth pain are recommended to see a dentist.
Non-Functional Jaw Activities
Going through each day, individuals tend to do things unconsciously or out of habit.
For example, individuals:
Reading or writing might chew on a pen or pencil.
Bite their nails or chew on the inside of their mouth while watching TV or internet browsing.
These activities can place stress on the joint, worsen the condition, and extend the healing process.
Resting on The Chin
Individuals will rest their jaw in their hands while studying, on social media, or watching TV.
This position can be comfortable, but it can affect the jaw.
This position can build pressure against the side of the jaw and push against the joint, causing the disc to shift out of place affecting how the jaw opens and closes.
Breaking the chin resting habit can allow the joint to relax and heal correctly.
Teeth Clenching
Bruxism is the medical term for clenching the teeth.
This can occur during the day or during sleep.
Teeth clenching is often brought on by stress and can place incredible pressure on the jaw’s muscles and worsen TMJ.
A dentist can prescribe a mouth guard to be worn while sleeping to protect the teeth from excessive clenching. (Miriam Garrigós-Pedrón, et al., 2019)
Slouching
The function of the jaw is closely related to body posture.
The jaw operates optimally when the head is above the cervical spine and the posture is upright.
Slouching can change how the jaw muscles work and the way the jaw opens and closes.
Part of physical therapy for TMJ is working on posture adjustments and training.
This can involve strengthening the back and shoulder muscles and setting up posture reminders.
Sitting and standing correctly can keep the jaw operating properly.
Postponing Treatment
Many with musculoskeletal issues and symptoms wait for the pain to go away.
Individuals having problems with their jaw should not wait to get treatment.
TMJ has a positive rate of recovery with conservative treatment, which is all the more reason to seek treatment. (G Dimitroulis. 2018)
A dentist or healthcare provider can provide an accurate diagnosis if TMJ is suspected.
Individuals can benefit from visiting a physical therapist to learn exercises and strategies to self-treat the condition. (Yasser Khaled, et al., 2017)
Treatment
Treatment can involve:
Initial treatment focuses on pain relief and jaw function opens and closes improvement.
A guard can help with night teeth grinding/bruxism.
Anti-inflammatory treatments.
In severe cases, surgery may be recommended to correct the problem, as a last resort. (Meghan K Murphy, et al., 2013)
Follow recommendations on what not to do and avoid certain activities.
Quick Patient Initiation
References
Schiffman, E., Ohrbach, R., Truelove, E., Look, J., Anderson, G., Goulet, J. P., List, T., Svensson, P., Gonzalez, Y., Lobbezoo, F., Michelotti, A., Brooks, S. L., Ceusters, W., Drangsholt, M., Ettlin, D., Gaul, C., Goldberg, L. J., Haythornthwaite, J. A., Hollender, L., Jensen, R., … Orofacial Pain Special Interest Group, International Association for the Study of Pain (2014). Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group†. Journal of oral & facial pain and headache, 28(1), 6–27. doi.org/10.11607/jop.1151
Santana-Mora, U., López-Cedrún, J., Mora, M. J., Otero, X. L., & Santana-Penín, U. (2013). Temporomandibular disorders: the habitual chewing side syndrome. PloS one, 8(4), e59980. doi.org/10.1371/journal.pone.0059980
Garrigós-Pedrón, M., Elizagaray-García, I., Domínguez-Gordillo, A. A., Del-Castillo-Pardo-de-Vera, J. L., & Gil-Martínez, A. (2019). Temporomandibular disorders: improving outcomes using a multidisciplinary approach. Journal of multidisciplinary healthcare, 12, 733–747. doi.org/10.2147/JMDH.S178507
Dimitroulis G. (2018). Management of temporomandibular joint disorders: A surgeon’s perspective. Australian Dental Journal, 63 Suppl 1, S79–S90. doi.org/10.1111/adj.12593
Khaled Y, Quach JK, Brennan MT, NapeÑas JJ. Outcomes after physical therapy for the treatment of temporomandibular disorders. Oral Surg Oral Med Oral Pathol Oral Radiol, 2017;124(3: e190. doi:10.1016/j.oooo.2017.05.477
Abouelhuda, A. M., Khalifa, A. K., Kim, Y. K., & Hegazy, S. A. (2018). Non-invasive different modalities of treatment for temporomandibular disorders: a review of the literature. Journal of the Korean Association of Oral and Maxillofacial Surgeons, 44(2), 43–51. doi.org/10.5125/jkaoms.2018.44.2.43
Murphy, M. K., MacBarb, R. F., Wong, M. E., & Athanasiou, K. A. (2013). Temporomandibular disorders: a review of etiology, clinical management, and tissue engineering strategies. The International journal of oral & maxillofacial implants, 28(6), e393–e414. doi.org/10.11607/jomi.te20
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